tbuckley/cabot-search huggingface dataset:
Poster No. 127 Intravenous statin administration during myocardial infarction mitigates cardiac damage and preserves cardiac function in diabetic cardiomyopathy rats
Authors: Sebastian Alcover, Sergi López, Lina Badimon, Gemma Vilahur
Journal: Cardiovascular Research (2022)

Abstract Introduction Diabetic patients may develop diabetic cardiomyopathy (DCM) and are at increased risk of myocardial infarction (MI). Yet, cardioprotection remains a challenge in the presence of comorbidities. Objectives We examined whether intravenous administration of atorvastatin during ongoing myocardial ischemia prevents against the deleterious effects of MI in DCM rats. Methods DCM was induced by streptozotocin (65 mg/kg) in Sprague Dawley rats (n = 14). 5 weeks thereafter animals exhibited a DCM phenotype associated with a significant diastolic (IVRT + 15.64 ± 5.49ms P &amp;lt; 0.05 vs. baseline) and systolic (LVEF, −8.63 ± 6.71% P &amp;lt; 0.05 vs. baseline) ventricular dysfunction. AMI was then induced by coronary ligation of the LAD for 45minutes. Early after ischemia (15minutes) DCM-rats received either i.v atorvastatin or vehicle. Animals were reperfused and sacrificed at 24h for infarct size assessment and molecular analysis. Cardiac function was monitored by echocardiography. Results No differences were detected as per the area-at-risk between both animal groups. Atorvastatin significantly reduced infarct size expansion (35% relative reduction) as compared to vehicle (15.3 ± 1.03% vs. 23.7 ± 4.3% IS/AAR; P &amp;lt; 0.05). LVEF, shortening fraction, and stroke volume were better preserved in atorvastatin-treated DCM rats as compared to vehicle (4.62 ± 2.55% vs. 12.4 ± 3.16%; 5.77 ± 3.74% vs. 15.9 ± 4.9%; and 58.93 ± 28.79μl vs. 101.73 ± 31.58 μl, respectively; P &amp;lt; 0.05). At a molecular level, atorvastatin administration was associated with a lower expression of Phosphorylated-p53 (apoptosis) and higher P-AMPK/AMP ratio (cardiac metabolism); P &amp;lt; 0.05 vs. vehicle). Conclusion Intravenous administration of atorvastatin during MI limits infarct size and preserves cardiac function post-MI in rats with manifest DCM supporting the cardioprotective potential of this therapeutic approach despite comorbid conditions.
Poster No. 027 Clinical, echocardiographic, analytic and anatomical parameters: which are the main prognostic factors in hospitalized patients with acute pulmonary embolism?
Authors: Fabiana Duarte, M Inês Barradas, Luís Oliveira, Inês Coutinho Dos Santos, Carina Machado, Raquel Dourado, Dinis Martins
Journal: Cardiovascular Research (2022)

Abstract Background Acute pulmonary embolism (PE) is a life-threatening disease and an early diagnosis and herapy are crucial. Several parameters for risk stratification have been evaluated and it's important to assess their impact on clinical practice. Objective We assessed four different parameters (clinical, echocardiographic, analytical and anatomical imaging parameters) - PESI class; PESI-Echo score; lactate and troponin I values and central or peripheral thrombi location. We determined a composite outcome of adverse events: shock, acute ventilatory failure, severe bleeding events or in-hospital mortality. Methods Retrospective single center analysis including 131 patients admitted for PE. Results Mean age of 67.6 ± 15.3 years-old and 71% patients were female. Eighty patients (63.4%) had arterial hypertension, 27.4% had a recent hospitalization or surgery and 16% an active neoplasm disease. According to the PESI classification, 29.8% of the patients were in class V, 26.7% in class III and 17.6% in class II. This classification had a weak positive correlation with the outcome (P &amp;lt; 0.001; r = 0.37) as PESI-Echo score (p 0.018; r = 0.36). The majority (72.2%) of the in-hospital adverse events occurred in PESI class V patients. Analytic parameters determined at hospital admission had a good discriminative power to predict the outcome, mainly lactate value (AUC 0.864; P &amp;lt; 0.001). PESI-Echo score presented the best discriminative power (AUC 1.0), followed by PESI class (AUC 0.925) and lactate (AUC 0.856). The cut-off value for PESI-Echo was 211. Conclusion The association of clinical and echocardiographic parameters was superior as a predictor of adverse events when compared with their isolated use.
Poster No. 026 Prognostic value of cardiac biomarkers in acute pulmonary embolism: can it add something?
Authors: Fabiana Duarte, M Inês Barradas, Luís Oliveira, Inês Coutinho Dos Santos, Carina Machado, Raquel Dourado, Anabela Tavares, Dinis Martins
Journal: Cardiovascular Research (2022)

Abstract Background Acute pulmonary thromboembolism (PE) is a life-threatening disease. Cardiac biomarkers like lactate, NT-proBNP and troponin I have been reported to predict prognosis of acute PE however, the prognostic importance of these factors on long-term mortality is not known. Objectives To assess the prognostic role of biomarkers lactate, NT-proBNP and troponin I in acute PE. Methods: We retrospectively assessed 131 consecutive patients diagnosed with acute PE. Prognostic impact of both lactate, NT-proBNP and troponin was assessed. Results Out of 131 patients with acute PE, the median age was 67.6 ± 15.3 years and 71.0% were female. Mean follow-up was 44.8 ± 37.3 months. Overall in-hospital mortality was 8.4%, 30-day mortality 13.0% and 1-year mortality 20.6%. Twenty-six patients (19.8%) had a recent hospitalization and 21 (16.0%) a medical history of active cancer. ROC curves shown that lactate has a good discriminatory power for in-hospital mortality, with an area under the curve (AUC) of 0.84 and p-value 0.001, unlike NT-proBNP (AUC 9.45, p-value 0.76) and troponin (AUC 0.64, p-value 0.12). Serum lactate equal or superior to 2.05 mmol/L were associated with higher in-hospital mortality (odds ratio [OR] 23.1, 95% confidence interval (CI) 2.8–187.7), when compared with lower levels. The impact of this parameter was independent of hypotension, tachycardia or active neoplasia (p-value 0.006, OR 21.3, 95% CI 2.4–187.3). Conclusions This study revealed that lactate has a better discriminatory power when compared to NT-proBNP and troponin in predicting prognosis in acute PE patients. Its routinely addition to current stratification tools could be of interest.
Poster No. 118 TheIL6rs1800795polymorphism is associated with ascending thoracic aortic dilatation in bicuspid aortic valve patients
Authors: Isabel Rodríguez, Alejandro Junco-Vicente, Valeria Rolle-Sóñora, Álvaro Del Río-García, Guillermo Solache-Berrocal, César Morís, María Martín Fernández
Journal: Cardiovascular Research (2022)

Abstract Antecedentes Los pacientes con válvula aórtica bicúspide (BAV), en comparación con las personas con válvula aórtica tricúspide normal, tienen un mayor riesgo de desarrollar dilatación de la aorta ascendente (DAA). La disfunción valvular significativa no explica una complicación aórtica desafortunada y, por lo tanto, los mecanismos moleculares involucrados se encuentran bajo investigación. Uno de los procesos involucrados es la inflamación y las citocinas como la interleucina-6 están asociados con las dimensiones aórticas y con la degeneración de la matriz extracelular aórtica en modelos animales. . Por este motivo, nos propusimos analizar un polimorfismo del gen de la interleucina-6 (IL6), que regula positivamente la transcripción y traducción del gen, en pacientes con VAB. Material y métodos Presentamos una serie de 119 pacientes con VAB genotipados para el polimorfismo rs1800795 en la región promotora del gen IL6 . Se realizaron modelos de regresión logística multivariable. Resultados y conclusiones Nuestros pacientes, todos con VAB, tenían una mediana de edad de 55 años, 76,5% hombres, 29,4% fumadores, 30% dislipidémicos, 35,3% hipertensos, 12,6% diabéticos y 44% con DAA de 39 a 49 mm. Homocigotos El genotipo para el alelo C del polimorfismo IL6 fue significativamente menos frecuente en pacientes con dilatación (OR = 0,32, IC del 95% = 0,11–0,96, P = 0,035). Tras ajustar por variables de confusión como sexo, edad, hipertensión arterial y valvulopatía, los pacientes portadores del genotipo CC seguían teniendo menor probabilidad de padecer DAA (OR = 0,25; IC95% = 0,07–0,76; P = 0,02). La identificación de individuos con predisposición genética para el desarrollo de DAA es fundamental en beneficio de un seguimiento médico más estrecho. Son necesarios más estudios para evaluar su uso en la aortopatía bicúspide. Investigación financiada por la Sociedad Española de Cardiología; ISCIII-PI1800694; Fundación-Asturcor;Programa Severo-Ochoa.
Poster No. 094 Age-dependent decline in common femoral artery flow-mediated dilation and wall shear stress in healthy subjects
Authors: Mariam Bapir, Simon S Skene, Paola Campagnolo, Christian Heiss
Journal: Cardiovascular Research (2022)

Abstract Background Femoral artery (FA) endothelial function is a promising biomarker for peripheral artery disease (PAD) prevention. We assessed FA flow-mediated dilation (FMD) in healthy adults of various ages. Material and methods Repeated common FA and brachial artery (BA) FMD measurements were performed with ultrasound induced by5 minutes distal cuff occlusion (thigh, calf, forearm) to assess intra- and interindividual variability and acceptability (n = 10). We then performeda cross-sectional study with FA- and BA-FMD measurements in healthy participants aged 18–80 (n = 53). Results and conclusions All FMD protocols had good reproducibility with average deviation of −0.1% (SD 0.6%, 0.9%, 0.6%) but thigh occlusion was less well tolerated. BA- and FA-FMD with thigh occlusion did not significantly differ while FA-FMD with calf occlusion was significantly lower (−1.0 ± 0.9%). Both FA-FMD and BA-FMD inversely correlated with age and baseline diameter and positively with wall shear stress (WSS). FA-FMD and BA-FMD correlated significantly (r = 0.57, P &amp;lt; 0.001). The baseline diameter was significantly greater in the FA as compared to the BA while the WSS was significantly lower. At the onset of reactive hyperaemia, the mean flow velocity, WSS and flow reserve were lower in the FA as compared to the BA. A large proportion of FA WSS values in older participants were below 5 dyne/ cm2 which is regarded as pro-atherogenic. FA endothelial function declines with age in parallel with the BA. FAs exhibits stronger age-dependent enlargement as compared to the BA leading to a critical decrease in WSS that may explain part of the age-dependent predisposition for PAD.
Clinical Case 04—Percutaneous patent foramen ovale closure after a thrombotic storm: a case report
Authors: André Alexandre, David Sá Couto, André Luz, António Marinho, Filomena Oliveira, João Silveira, Severo Torres
Journal: Cardiovascular Research (2022)

Abstract A 38-year-old woman with a 32-week gestation was admitted in the emergency department complaining of acute lower limb pain. She had history of smoking, 1 voluntary interruption of pregnancy, 1 miscarriage at age 34, and family history of antiphospholipid syndrome (APS). At admission, bilateral acute limb ischemia and foetal death were diagnosed. CT angiography revealed acute bilateral thrombotic occlusion of the iliac arteries, left renal artery thrombosis with extension to the distal abdominal aorta, deep vein thrombosis (DVT) of the left iliac vein and distal inferior vena cava, and bilateral pulmonary embolism. The patient started on anticoagulation and underwent caesarean section and axillobifemoral bypass. Plasmapheresis and rituximab were attempted due to high clinical suspicion of catastrophic APS. Immunological and neoplastic study were repeatedly negative. The patient was ultimately discharged on vitamin K antagonist (VKA). Further investigation revealed a patent foramen ovale (PFO) with spontaneous right-to-left shunt. Given the risk of paradoxical embolism in this thrombophilic setting of unclear cause, she was referred for percutaneous PFO closure using a GORE® CARDIOFORM 25 mm device. Post-procedure maintenance of antithrombotic therapy with VKA was decided by a multidisciplinary team. Since the event, she had no recurrence of thromboembolic events and continues under investigation in autoimmune disease outpatient clinic. Although simultaneous arterial and venous thrombosis cannot be ruled out, we suspect of left paradoxical embolism following DVT. PFO closure in this setting might be useful for reduction of paradoxical arterial embolism risk on top of systemic anticoagulation. Figure 1Panels A and B show the presence of patent foramen ovale (PFO). Panels C and D show the final result after percutaneous PFO closure using a GORE® CARDIOFORM 25 mm device.
Poster No. 139 Direct Oral Anticoagulant Use in the Treatment of Venous Thromboembolism Associated with Cancer
Authors: Francisca Carmo, Joana Martins Cabral, Luísa Magalhães
Journal: Cardiovascular Research (2022)

Abstract Venous thromboembolism (VTE) is a common cause of death and complications in patients with cancer. Choosing an anticoagulant is challenging because these patients are at high risk of recurrent VTE and bleeding. Major guidelines recommended the use of low-molecular-weight heparin (LMWH), but recent studies recommend consideration of direct anticoagulants (DOACs) in selected patients. However, their clinical use is limited by the increased risk of bleeding and interaction with other drugs. Retrospective study, including patients followed since 2015 in VTE consultation, with cancer-associated VTE. Patients with an ECOG Performance Status Scale of 4 and with contraindications for anticoagulation were excluded. We reported the incidence of recurrent VTE and haemorrhage within the first year after anticoagulation. In this study, we compared the efficacy and safety of the use of DOACs versus LMWH in patients with cancer-associated VTE. 91 patients were included, 55% male, median age of 70 years and most frequent ECOG Performance Status Scale of 0 (44%). 65% of the patients were treated with DOACs. The most common cancers included: colorectal (26%), genitourinary (25%), haematological (10%) and upper gastrointestinal (9%). Were reported 6 recurrent VTE events (4 pulmonary embolisms, 2 deep vein thrombosis) and 6 minor bleeding events, without any major or fatal event. The occurrence of recurrent thromboembolic events or bleeding was not significantly different between patients treated with LMWH or DOACs. In this real-world observational study, we confirm the efficacy and safety of the use of DOACs in the treatment of VTE associated with cancer in selected patients.
Oral Presentation No. 75 Impact of thoracic aortic calcification measured by computed tomography in clinical outcomes in patients undergoing cardiac surgery
Authors: Margarida Cabral, Diana Carvalho, Rita Veiga, Mónica Carvalho, Wilson Ferreira, Rita Faria, Ricardo Ladeiras-Lopes, Nuno Ferreira
Journal: Cardiovascular Research (2022)

Abstract The presence of thoracic aortic calcification (TAC) has been shown to increase the risk of cardiovascular and cerebrovascular events. Few studies have evaluated the relationship between CT measured by computed tomography (CT) before cardiac surgery and clinical outcomes, and the relationship is still unclear. This study aimed to analyse the impact on clinical outcomes of the presence of TAC in patients undergoing cardiac surgery. A retrospective unicentre analysis of patients undergoing a noncontrast CT prior to cardiac surgery was performed. TAC was quantified using a volume-rendering method. The percentiles of TAC volume (TACV) were used to determine the relative standing. Demographic data, risk factors and clinical outcomes were comparable between groups. A P-value &amp;lt; 0.05 is statistically significant. The mean TACV was 2.45 ± 2.79 cm3, and the median and 75th percentiles were 1.45 and 4.06 cm3, respectively. Of the total of 121 patients, 26 (21.5%) had high TACV. Table 1 shows the baseline demographic and risk factors. There was no significant difference in risk factors and personal history between groups except for age (P-value = 0.02), hypertension (P-value = 0.04) and coronary artery disease (P-value &amp;lt; 0.01). Regarding clinical outcomes, there was no significant difference in clinical outcomes except for acute kidney failure (P-value = 0.04), which was not significant in multivariate analysis. In conclusion, aortic calcification is a recurrent finding, to which there seems to be a contribution from hypertension-related vascular damage, especially in older ones. In patients undergoing cardiac surgery, TACV appears not to be related to clinical outcomes in multivariate analysis. However, large-scale studies are needed to confirm these results.
Poster No. 122 Predicting the rate of progressive dilation by wall shear stress in bicuspidaortic valve patients
Authors: Jose Rodriguez-Palomares, Lydia Dux-Santoy, Gisela Teixidó-Turà, Aroa Ruiz-Muñoz, Juan Garrido-Oliver, Kevin Johnson, Oliver Wieven, Laura Galian, Filipa Valente, Laura Gutierrez, Teresa Gonzalez-Alujas, Augusto Sao-Aviles, Arturo Evangelista, Ignacio Ferreira-Gonzalez, Andrea Guala
Journal: Cardiovascular Research (2022)

Abstract Background Despite the high prevalence of ascending aorta (AAo) dilation in bicuspid aortic valve (BAV) patients there is limited evidence of dilation aetiology. Several cross-sectional studies pointed to a role for wall shear stress (WSS), but this hypothesis has not been tested. Recently, a technique for 3D-maps of aortic growth from two contrast-enhanced computed tomography angiograms (CTA) was presented and validated. We aim to test if local WSS predicts local dilation rates in BAV patients. Materials and methods Forty BAV patients free from aortic valve disease and previous relevant interventions underwent a baseline 4D flow CMR followed by two CTA. WSS, and its axial and circumferential components, and growth rate (GR) were computed at 64 standardized regions in the ascending aortic (AAo). A two-tailed p-value &amp;lt; 0.05 was considered statistically significant. Results and conclusions Patients were relatively young (51 ± 13 yeas) and follow-up duration was 44.8 ± 2.6 months. Growth rate was heterogeneous in the AAo, with fastest progression located in the outer mid AAo region and in the inner region of the proximal-mid AAo. WSS magnitude and WSS axial component were maximum in the right region of the mid AAo while circumferential WSS was highest in the outer region of the mid AAo, the region experiencing fastest growth. Significant associations between GR and circumferential WSS were located in the regions with fastest progressive dilation, while WSS magnitude and its axial component resulted in limited predictive capacity. In conclusion, circumferential WSS is related to fast progressive dilation in BAV patients. Funding PI17/00381,SEC/FEC-INV-CLI20/015,LCF/BQ/PR22/11920008,RTC2019-007280-1.
Clinical Case 01—Cardioembolic stroke with a twist: a case of left ventricular thrombus
Authors: Adriana Vazão, Carolina Miguel Gonçalves, Rui Filipe Ribeiro, Ana Catarina Domingues, Margarida Cerqueira, João Filipe Carvalho, Maria de Jesus Banz, João Morais
Journal: Cardiovascular Research (2022)

Abstract Presentation and diagnosis A 62-years old male was brought to the emergency department after being found unconscious, lying on his left side. He was last seen 1 week before. Past medical history revealed ischemic cardiomyopathy with reduced ejection fraction of 35% after ST-segment elevation myocardial infarction 3 months before, subject to coronary angioplasty of 2 vessels (left anterior descending artery with drug-eluting stent and circumflex artery with balloon angioplasty). He had poor therapeutic compliance with missing cardiology appointments. On examination, he was hypothermic and hemodynamically unstable with signs of hypoperfusion. He was admitted for septic shock with origin in a decubitus ulcer on his left-hand dorsum. Head CT-scan revealed sub-acute ischemic stroke in the right middle cerebral artery territory. He started fluid therapy, vasopressors and large spectrum antibiotics with favorable clinical evolution and no heart failure symptoms but remained febrile. Meanwhile, Proteus hauseri had grown in blood cultures. An echocardiography was performed excluding infectious endocarditis and revealing a large apical thrombus on the left ventricle. Management Therapeutic anticoagulation with enoxaparin was initiated and antibiotic was de-escalated according to the antibiogram. Later on, anticoagulation was switched to warfarin (target INR∼2.0–3.0). When clinically stable, was discharged home with anticoagulation and clopidogrel, with an echocardiography scheduled after 3 months. Learning points Left ventricular thrombus is a rare complication of ischemic cardiomyopathy with high risk of adverse outcomes, including ischemic stroke and death. Vitamin K antagonists are usually preferred to direct oral anticoagulants in the management of these patients, but further research is needed.
Poster No. 135 Stroke risk of patients with new AF during ACS may depend on onset and duration
Authors: Wilbert Bor, J Azzahhafi, N di Maio, N M R Van Der Sangen, S Rayhi, J Peper, J M Ten Berg
Journal: Cardiovascular Research (2022)

Abstract Background/rationale Newly diagnosed atrial fibrillation(AF) during acute coronary syndrome(ACS) is associated with worse outcomes. In this study we evaluated the associated stroke risk of newly diagnosed AF in ACS patients according to the onset and duration of the episode. Results Amongst 4433 patients presenting with ACS, 439(9.9%) had newly diagnosed AF and 396(8.9%) had known AF. Of the new AF cases, 27.5% occurred post-CABG. The onset was within 24 hours of ACS presentation in 70.1% of non-CABG cases. The new AF episodes lasted longer than 24 hours in42.9% of the non-CABG cases. At discharge 54.0% of patients with new AF was treated with OAC, in contrast to 89.2% with known AF. The incidence of ischemic stroke at one year was 1.2% in patients without AF, 1.0% with known AF, and 3.6% with new AF(P &amp;lt; 0.001). Within patients developing AF post-CABG, the incidence was 4/120(3.3%). Within non-CABG patients, the incidence of ischemic stroke for patients with onset within 24 hours of presentation was 0/133(0.0%) for patients with an episode lasting &amp;lt; 24 hours, and 6/109(5.5%) for patients with an episode lasting &amp;gt; 24 hours. For patients with new AF onset after 24 hours the incidence was 5/120(5.5%) for patients with an episode lasting &amp;lt; 24 hours, and 5/92(5.4%) for patients with an episode lasting &amp;gt; 24 hours. Conclusion Patients with newly diagnosed AF during ACS seem undertreated with OAC. The associated risk of ischemic stroke with new AF during ACS may be lower in episodes that terminate within the first 24 hours of presentation.
Retracted: Poster No. 023 Indian Consensus for the Utilisation of Combination of Dual Antiplatelet (DAPT) and Statin therapy for the Stratified Treatment of Acute Coronary Syndrome (ACS)
Authors: Jay Shah, Prashant Kharche, Ajeya Mundhekar, Pradeep R Kumar, Soumik Chaudhuri, Joy Sanyal, Sukriti Bhalla Singh, Omer Mustafa Hasan, Saikat Kanjilal, Ameya Mt, Sadiq Azam, V S R Bhupal
Journal: Cardiovascular Research (2022)

This abstract has been withdrawn. Please see: https://doi.org/10.1093/cvr/cvac183